TY - JOUR
T1 - Dying trajectory in the last year of life
T2 - Does cancer trajectory fit other diseases?
AU - Teno, J. M.
AU - Weitzen, S.
AU - Fennell, M. L.
AU - Mor, V.
PY - 2001
Y1 - 2001
N2 - Purpose: To examine differences in the pattern of functional decline among persons dying of cancer and other leading noncancer causes of death. Design: Mortality followback survey of next of kin listed on death certificate. Setting: Probability sample of all deaths in the United States. Participants: Next of kin for 3,614 decedents that represented 914,335 deaths. Measurements: Days of difficulty with activities of daily living and mobility in the last year of life. Results: Relative to other decedents, patients with cancer experienced an increased rate of functional impairment beginning as late as 5 months prior to death. For example, only 13.9% of patients with cancer had difficulty getting out of bed or a chair 1-year prior to death. This increased from 22.2% to 63.0% in the last five months of life. In contrast, decedents from other diseases had higher rates of functional impairment 1 year prior to death (approximately 35% had difficulty getting out of bed or chair) and they manifested a more gradual increase in the level of functional decline (approximately 50% had difficulty getting out of bed). Precipitous functional decline was associated with hospice involvement and dying at home. Conclusion: Persons dying of cancer experienced sharp functional decline in the last months of life whereas other decedents' have a more gradual decline. The more precipitous functional decline was associated with hospice involvement and dying at home.
AB - Purpose: To examine differences in the pattern of functional decline among persons dying of cancer and other leading noncancer causes of death. Design: Mortality followback survey of next of kin listed on death certificate. Setting: Probability sample of all deaths in the United States. Participants: Next of kin for 3,614 decedents that represented 914,335 deaths. Measurements: Days of difficulty with activities of daily living and mobility in the last year of life. Results: Relative to other decedents, patients with cancer experienced an increased rate of functional impairment beginning as late as 5 months prior to death. For example, only 13.9% of patients with cancer had difficulty getting out of bed or a chair 1-year prior to death. This increased from 22.2% to 63.0% in the last five months of life. In contrast, decedents from other diseases had higher rates of functional impairment 1 year prior to death (approximately 35% had difficulty getting out of bed or chair) and they manifested a more gradual increase in the level of functional decline (approximately 50% had difficulty getting out of bed). Precipitous functional decline was associated with hospice involvement and dying at home. Conclusion: Persons dying of cancer experienced sharp functional decline in the last months of life whereas other decedents' have a more gradual decline. The more precipitous functional decline was associated with hospice involvement and dying at home.
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U2 - 10.1089/109662101753381593
DO - 10.1089/109662101753381593
M3 - Article
C2 - 11798477
AN - SCOPUS:0035663063
SN - 1096-6218
VL - 4
SP - 457
EP - 464
JO - Journal of palliative medicine
JF - Journal of palliative medicine
IS - 4
ER -